UnitedHealthcare Community Plan KanCare

Medicaid

This plan offers a range of benefits along with extras that other KanCare plans don't offer. We also offer extra support and care to adults and children who need help with daily activities. You qualify based on income and health needs. View the benefits below to see all that it offers.

本計劃在所有郡提供。

More information on eligibility and enrollment can be found on the KanCare website.

Announcements for UnitedHealthcare KanCare members can be found below:

承保福利和特點

康復與生病照護

Get the care needed to stay healthy — or to be at your best. 這包括:

  • Choice of Doctors. Find a doctor you know and trust in our network.
  • Medicines. Fill your prescriptions at local pharmacies.
  • Lab and X-rays. Lab tests, x-rays and diagnostic imaging are covered.
  • Therapy Services. Physical or other therapy to help be your best.
  • Shots and Vaccines. Routine shots help protect against illness.
  • Hospitalization. You pay nothing for care in a hospital.
  • NurseLine℠. Speak with a registered nurse 24/7.
  • Foot Care. We provide more visits to keep your feet healthy.
  • Community Rewards. You can earn rewards for going to important wellness exams.

沒有什麽比您和您的孩子的健康更重要。That's why our plan benefits include:

  • Choice of Birth Center. You can choose a licensed community birth center or pick from 100s of hospitals across Kansas.
  • Choice of Doctors. Find a certified nurse midwife, licensed midwife, doctor or OB/GYN you trust in our network.
  • Healthy First Steps®. Get extra support and rewards to keep you and your baby healthy.
  • Prenatal Visits. Care for you before your baby is born. Earn reward for completing first prenatal visit in the first trimester.

If you or a family member has special health care needs, you can count on us. Our plan will provide the needed extra care and services. 承保福利範圍包括:

  • Behavioral Health. Counseling and other treatments are covered.
  • Diabetic Support. Medicine needles and wipes for managing diabetes.
  • Asthma and COPD Support. Exams, testing and supplies are covered.
  • Care Management. If you qualify, get personal help managing health conditions.
  • Kidney Disease Care. Dialysis, medicine and treatments are covered.
  • Health Rewards Program. Earn debit card rewards for well care visits and immunizations.

Make sure your sight, smile and hearing are at their best. 承保福利範圍包括:

  • Vision Care. Yearly eye exams and eyeglasses as needed.
  • Dental Care. Exams, x-rays and cleaning for kids and adults.
  • Hearing Care. Tests, checkups and hearing aids, if needed.

If you are recovering from a serious illness or surgery, you may need extra support. Our plan includes the care and equipment needed to recover safely at home. 承保福利範圍包括:

  • Equipment and Supplies. In-home medical and safety equipment are covered.

有時在使用您的健康計劃時您可能需要少許額外幫助。此時,您可以依靠:

  • Transportation. We provide rides to and from medical visits.
  • Community Rewards. Your can earn rewards for going to important wellness exams.
  • Programs for Kids and Teens. Free activities at local youth organizations.
  • Member Services. Your benefit questions are answered Monday – Friday 8 am – 6 pm 1-877-542-9238.
  • Quitting Tobacco. Coaches and supplies to help you quit using tobacco.
  • Interpreters. Interpreters are available over the phone for you at your doctor visits.

If you're elderly or living with a disability or illness, your health needs are unique. Our job is to make it as easy as possible for you to meet those needs and more. Benefits may include:

  • Care Coordinator. Someone to get you the services to be at your best.
  • Disease Management. Focused care for those with critical health needs.
  • In-Home Care. Medical and personal care at home, if needed.
  • Equipment and Supplies. In-home medical and safety equipment are covered.
  • Emergency Response System. Sends an urgent request for someone to help you.
  • Adult Day Care. Friendship and social activities in a safe setting.
  • Home Meal Delivery. If you cannot safely make meals, we'll provide them.
  • Respite Care. In-home help to give your caregivers a rest.

Adult Day Care

Companionship is important. Adult day care provides care and companionship for frail elderly waiver members who need extra help during the day. Caregivers also benefit, knowing their loved one is well cared for and safe during the day.

Adult day care can provide:

  • Social connections and friendship.
  • Bathing and personal care.
  • Meals.

Asthma and COPD Support

Do you or a family member have trouble managing asthma or COPD symptoms? A nurse who specializes in breathing issues can really help. You will get a customized treatment plan and medicine to:

  • Manage flare-ups.
  • Reduce symptoms.
  • Help you stay active.

Attendant Care Services

If you live with a disability or chronic health condition, you may need extra help to stay in your own home. Our plan gives members who qualify the services needed to be safe and comfortable. An attendant can provide:

  • Companionship.
  • Homemaking services.
  • 個人照護。

You and your caregiver can decide which chores you want your care attendant to do in your home.

行為保健

行為健康與身體健康一樣重要。這就是我們對兩方面均提供承保的原因。

Required care is 100% covered with no copay. 這些包括:

  • 行為治療。
  • 物質濫用治療。
  • 藥物。
  • Peer Coaching program.

Care Coordinator

The daily care and safety of our members is important. That’s why we conduct home visits for eligible waiver members who need extra help staying at home. 

During this visit we:

  • Understand your personal needs.
  • See if your home needs minor modifications, such as ramps and bathroom safety devices.
  • Set up emergency monitoring.
  • Arrange for personal care attendants.

Care Management

Do you have a disability or a serious health problem? If your health needs qualify then our care coordinators are in your corner. They will:

  • Explain medical terms in plain language.
  • Coordinate your doctor appointments.
  • Provide your care team with your medical records.

Your care coordinator will stay with you throughout the medical journey. He or she will:

  • Think beyond your immediate medical needs.
  • Make sure you have support at home.

選擇生產中心

在哪裡生孩子是一項重要決定。That's why you can pick from hospitals across Kansas and surrounding states.

We also encourage you to tour the hospital's birthing center. 這樣您可以熟悉它。And be more relaxed when you have your baby.

Cell Phone Program

Contact Member Services for help applying for a cell phone plan.

Choice of Doctors

您的主要照護醫師 (PCP) 就是您的主治醫師。使用醫師查詢來查看您的醫師是否在我們的網路內。

If you don't have a doctor or if your doctor is not in our network, we can help you find a new one close to you.

您的主要照護醫師 (PCP) 就是為您提供下列服務的主治醫師:

  • 預防照護。
  • 在您生病或受傷時為您治療。
  • 針對您的特殊健康問題,將您轉診給專科醫生。

牙齒保健

Child members up to age 20 receive Preventative exams and cleaning 2 times a year. This helps keep teeth and gums strong and healthy.

Adults over 20 can visit participating dental provider for exams, x-rays, cleanings and fillings. Covers up to $500 per year*.

*The $500 coverage that includes fillings begins in 2019

糖尿病患者支持

If you have diabetes, we'll help make life a little easier for you. 您將獲得藥物、用品和教育資訊,協助您達到並維持最佳狀態。

Our diabetes program also includes self-care training and classes focused on:

  • Planning healthy meals.
  • Managing stress.
  • Living a healthy lifestyle.
  • Wellness Rewards for getting needed exams.

疾病管理

If you have chronic or high-risk illnesses, our disease management services may help you. We provide support for:

  • Congestive heart failure.
  • 氣喘。
  • HIV.
  • Chronic obstructive pulmonary disease (COPD).
  • Coronary artery disease.

Emergency Response System

If you are on one of the waiver programs and at risk for a fall or sudden illness, an emergency call system can really help. It sends an urgent request for someone to check on you and help you.

Equipment and Medical Supplies

您在家中的健康和安全很重要。

Our plan covers medical equipment ordered by your doctor. This might include supplies like:

  • 氧氣罐。
  • 醫療用床
  • 輪椅或助行器。

足部照護承保

Children can get the exams needed to help keep your feet in great shape. And if you have diabetes, good foot care can help prevent much more serious problems.

我們的足科承保包含:

  • Routine foot exams.
  • 提供足部照護以及如何選擇合適鞋類的有用秘訣。
  • 提供神經受損警兆的相關資訊。

健康首要步驟 (Healthy First Steps®)

加入「Healthy First Steps」計劃,爲您和您的寶寶創造健康的未來,並賺取豐厚獎勵。我們的計劃將幫助您採取正確的步驟來保持您和寶寶的健康。此外,註冊還可以賺取$20獎勵。

我們將幫助您:

  • 選擇懷孕服務提供者和兒科醫師(孩子的醫師)。
  • 預約就診和檢查,並安排就診接送服務。
  • 您在整個懷孕期間和寶寶 15 個月大之前參與就診可獲得獎勵。
  • 獲取用品,包括哺乳媽媽的擠奶器。
  • 與社區資源聯繫,例如女性、嬰兒和兒童 (Women, Infants and Children, WIC) 服務。

聽力照護

聽力障礙會在很多方面對您的日常生活產生影響。我們的計劃包括幫助您保護聽力的服務和支援。

我們承保:

  • 檢查、治療和檢測。
  • Hearing aids when ordered by your doctor.

Home Meal Delivery

If you are on the PD or TBI waiver and live with a disability or chronic health condition, we may be able to arrange home meal deliver. You will not be eligible if you are getting home meals through different program.

住院

本計劃支付所有住院的相關費用,讓您安心靜養。

住院承保包括:

  • 照護。
  • 病房與餐宿。
  • 用品與設備。
  • 治療。
  • 診斷檢驗和檢查。

在您離開醫院後仍可獲得關懷。我們保證您可獲得後續照護幫助您在家治癒。

In-Home Care / Skilled Home Health Care Services

If you have health or mobility challenges, you may need extra help with day-to-day tasks. You may even need an in-home medical visit to check on how well you are healing. If ordered by a doctor for medical reasons, our Plan covers: 

  • In-home medical visits.
  • 醫療設備,如病床、助行器或輪椅。
  • 一次性醫療用品。
  • 個人照護或家務方面的協助。

翻譯人員

醫師和您需要相互瞭解,無法說流暢的英文會造成困難。We can arrange for a medical interpreter to be available for you over the telephone at your appointments.

我們也有保戶服務人員會說不只一種語言。我們可請到能夠說您的語言的人員,

腎臟病照護

腎臟病是一種嚴重的疾病。在腎臟停止正常運作後,會需要例行治療(稱為腎臟透析)或器官移植。透析使用機器清潔血液,如同健康腎臟做的工作一樣。我們的計劃包含以下項目:

  • 透析。
  • 藥物。
  • 健康教育和支持。
  • 器官移植(若需要)。

檢驗室檢驗和 X 光檢查

知道健康出了什麼問題,並及早找出問題所在,可能是成功治療的關鍵。我們的計劃承保:

  • 檢驗室檢驗。
  • X 光、掃描和其他影像技術。

We'll help you get the information needed to improve your health or be at your best.

藥物

There are no copays for covered drugs. You can fill your prescriptions at local pharmacies. 

The medical card will cover many services and items. In order for a service to be covered, you must use a Kansas Medicaid provider. The type of coverage you have will determine how you receive coverage.

Specific limits and guidelines apply to all services, and these change often. Before getting any service or item, contact KMAP/MCO Customer Service. A general list of KMAP/MCO covered services is included on our website at https://www.kmap-state-ks.us/Public/Beneficiary/default.asp.

Medicaid requires some services to be approved before you get them. Your provider knows which services need prior authorization and is responsible for obtaining it for you. Medicaid will send you and your provider a letter approving or denying the prior authorization request.

保戶權益維護人員

我們會協助您照顧健康。保戶權益維護人員可協助處理問題、提供訓練和教育,並且解決保戶的問題。

他們能夠:

  • 提供有關您計劃的資訊。
  • Teach you how to get the care you need.
  • 協助有關醫師的問題或不滿。
  • Call Member Services and ask for a Member Advocate to help you.

保戶服務

有時候您可能需要一些協助,以瞭解您的健康照護選擇。With us, you have someone you can call Monday-Friday 8 am - 6 pm at 1-877-542-9238. 我們將簡潔完整地回答您的問題。

我們還可以協助您尋找:

  • 醫師。
  • 藥房。
  • 醫院或其他保健設施。
  • 當地資源。

NurseLine℠

Medical questions and situations sometimes happen at inconvenient times. 當您有關於健康方面的疑問時,可致電護士,服務時間一週 7 天,一天 24 小時。Call 1-855-575-0136.

我們的護士將:

  • Listen to symptoms.
  • 協助自我照護。
  • 建議您看醫生或到緊急護理中心看診。
  • 幫助您了解什麽時間應該掛急診。

產前看診

Your pregnancy is a journey and you will need help along the way. You can visit a family doctor or pregnancy doctor (OB-GYN) to get the care you need.  

我們的計劃承保推薦的產前檢查和檢驗,

在看診時,診所將:

  • Make sure both you and your baby are healthy.
  • 說明您在懷孕期各個階段可能會有的症狀。
  • 回答您的問題。

Programs for Kids and Teens

Positive role models can make a big difference in a child's life. That's why we provide one free activity each year at local youth organizations, like:

  • YMCA.
  • Boys & Girls Clubs.
  • 4-H.
  • Select Kansas Park and Recreation Departments.

戒煙

You know the bad health effects of smoking. You know you need to quit. We support you while you quit with coaches and supplies. The only thing you won't get from us is a lecture.

You can also call the KanQuit smoking line at 1-800-784-8669 for support. 

留看護理

Are you a waiver member who has family members or friends who care for you in your home? 如果是這樣,我們也希望能支援他們的辛苦工作。所以我們提供喘息照護,讓您的照顧者休息一下。留看護理為照護人員提供了時間,讓他們可以離開他們關愛的或需要特殊照護的家人。Some members can get extra respite care. Ask your Care Coordinator if you qualify.

預防針和疫苗

例行預防針有助於不生病。因此,我們的計劃承保:

  • Pneumonia, influenza and shingles shots.
  • Tetanus, diphtheria, pertussis.
  • HPV.

治療服務

物理、職能和語言治療可協助您自嚴重傷害或疾病中恢復,或只是發揮您的全部潛力復原。

When approved by a doctor, covered therapies include:

  • 職業治療。
  • 物理治療。
  • 語言治療。

載送

Our plan provides needed rides to and from health care locations for medical appointments. That includes trips to:

  • Doctor or therapy visits.
  • Health departments.
  • Vision clinics.
  • Rides to job activities for members who qualify.

Call 1-877-524-9238.

視力照護

You'll get the care, eyeglasses and treatment that let you see life more clearly. 承保範圍包括:

  • Annual eye exams.
  • 處方鏡片。

This benefit is offered by OptiCare.

康復看診

康復看診可以幫助您保持健康。這些檢查可以及早發現健康問題並進行治療。預防保健服務包括:

  • 成人和兒童的健康檢查。
  • 施打例行預防針和檢測。
  • 乳房攝影檢查。

There are no copayments for preventive care. Earn Community Rewards points for getting exams.

保戶資源

檢視可利用的資源

深入了解

UnitedHealthcare Community Plan KanCare

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